The rash looked like a bit of leftover strawberry jam on the side of my then-3-year-old’s cheek. I ran through the usual symptom checklist to see if anything else was going on with him: no fever, aches or pains, and he wasn’t overly tired or cranky. A day later, the rash hadn’t expanded or disappeared, and he was acting like his usual cheerful self. With a shrug, we continued with our spring break visit with my parents.
It wasn’t until we returned home that one of my daughters and I developed fevers and sore throats. A trip to the doctor uncovered the culprit: My youngest had strep throat (apparently, the rash was a dead giveaway), and so did I and his four siblings. Later we learned we had generously given it to my mom and dad, too.
When it comes to sickness and kids, parents often feel torn between overreacting to each little bump, bruise and blister (don’t want to raise a hypochondriac!) or being overly blasé and misjudging an illness (like spreading strep throat all over southern Virginia).
“As a mom and a pediatrician, it’s even hard sometimes for me to make the right call about my own child’s illness,” said Alice Mar, a pediatrician at Farrell Pediatrics in Reston, Va. “Everybody occasionally downplays something and sends her child to school sick.”
Fortunately, there are some guidelines for parents to consider when trying to figure out if a trip to the doctor is necessary or if a home remedy would be best.
The child’s behavior. Samyra Sealy, a primary care specialist at Mercy Medical Center in Baltimore who is board certified in family medicine, recommends keeping an eye on how the child is acting. “If the child has a runny nose and cough but is eating, drinking and running around the house like normal, it’s probably okay to just watch him at home,” she said.
The child’s age. How young a child is can be an important factor in determining whether a doctor visit is needed. For example, a parent should consult a doctor for a fever or any ailment in infants under three months. “I always recommend parents call our office if the child is under a year with a fever,” Mar said. “Fever is common with viruses but sometimes it can be hard to tell if it’s something more worrisome in an infant or toddler.”
The length of illness. Symptoms, such as a fever or stomachache, that last longer than four or five days should trigger a doctor visit. “While lots of viruses can last up to a week, when symptoms persist or don’t get better, you should take the child to the doctor,” Mar said.
The severity of symptoms. If a symptom becomes worse — over a period of time or suddenly — medical attention should be sought. Mar pointed out that a severe headache, abdominal pain, urinary symptoms, a sore throat or dehydration should be addressed by a doctor.
The parent’s gut feeling. We know our children, and sometimes, something about the way she acts or he looks triggers that parental instinct that pushes us to seek medical care. One time, my youngest — 4 years old at the time — had been running a fairly “normal” fever for a few days, accompanied by congestion and a cough. On day three, something didn’t seem quite right, so off we went to the doctor, who took one listen with her stethoscope and diagnosed pneumonia in its early stage. “I encourage parents to listen to their gut feeling because if a parent really feels there’s something more wrong than meets the eye, she’s probably right,” Mar said.
We all want our kids to get better when they’re feeling ill, but it can be difficult to know how to treat minor ailments such as fevers and colds. “Cold symptoms can be often managed at home,” Sealy said. “Home remedies for a runny nose include a nasal saline to help loosen nasal mucous, while humidifiers (or a steamy bathroom) can help with congestion.”
For fever, acetaminophen or ibuprofen can help a child feel better — both doctors I spoke with said to follow the dosage instructions on the bottles for the best results. Mar also recommended honey for coughs but cautioned against giving the sweetener to children under a year old. “The main thing for sick kids is rest and drinking plenty of fluids,” she said.
Both doctors said that most over-the-counter cold medicines don’t work well and should be avoided for very young children. “Be mindful about inappropriate use of medications, including over-the-counter agents and also prescribed medications like antibiotics,” Sealy said. “Most times, antibiotics are not needed for run-of-the-mill colds or upper respiratory tract infections.”
Sick or well?
One of the hardest calls as a parent is when a child complains of feeling sick but there are no obvious symptoms, such as a fever, that keep them out of school. I’ve certainly sent a kid to school who was just feeling a bit under the weather and had to pick her up when a fever suddenly appeared in the afternoon.
Sealy advised closely monitoring the child by taking her temperature at intervals and observing her eating and bathroom habits. However, she pointed out that if a parent is concerned about her child, “there is no harm in talking to your child’s doctor about your concerns.”
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